Effect of dialysis prescription guided by body composition analysis on cardiovascular prognosis in ma-intenance hemodialysis patients with diabetic kidney disease
Objective To explore the effect of body composition analysis-guided dialysis prescrip-tion on cardiovascular prognosis in maintenance hemodialysis(MHD)patients.Methods All participants were selected among MHD patients admitted to Hemodialysis Center of the Tianjin Medical University Chu Hsien-I Memorial Hospital from August 2021 to December 2021.According to whether the patients adjusted their dialysis prescription according to the results of body composition detection,A total of 134 patients met the inclusion criteria and were divided into observation group(n=72)and control group(n=62).General profiles and laboratory parameters were recorded at baselines and followed up for 2 years.The all-cause death,cardiovascular death and cardiovascular events were observed in the two groups.Results At base-line,there were statistically significant differences in age,dialysis age,albumin,total protein,hemoglobin,blood urea nitrogen,serum creatinine,estimated glomerular filtration rate,triglyceride,total cholesterol,ferroprotein,serum chlorine,serum phosphorus,serum iron and CO2 binding power between the two groups(all P＜0.05).Dialysis prescription based on bioelectrical impedance analysis results was the independent protective factor in the occurrence of all-cause death(OR=5.188,95％CI:1.148-23.457,P=0.032),cardiovascular death(OR=15.618,95％CI:1.858-131.299,P=0.011)and cardiovascular events(OR=19.772,95％CI:3.096-126.284,P=0.002)in MHD patients.Age was an independent protec-tive factor for the occurrence of cardiovascular death(OR=1.072,95％CI:1.001-1.148,P=0.047)and cardiovascular events(OR=1.111,95％CI:1.022-1.207,P=0.013).Volume abnormalities were inde-pendent risk factors for all-cause death(OR=7.979,95％CI:1.162-54.784,P=0.035)and cardiovas-cular events(OR=73.059,95％CI:1.955-2 730.652,P=0.020).Conclusion Dialysis prescription based on body composition analysis significantly improves cardiovascular prognosis in MHD patients,with in-dependent protection against cardiovascular events,cardiovascular death,and all-cause death.Overhydra-tion is a predictor of the risk of all-cause death and cardiovascular events in MHD patients.
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